The Learning and Study Strategies of College Students with ADHD

I presented this poster at the 2005 APA convention in Washington, DC. It discusses a study I conducted on the Learning and Study Strategies of College Students with ADHD, which compared them to their peers with and without Learning Disabilities. The study was also published in Psychology in the Schools.

ADHD and Neurofeedback

Here are two good Videos about ADHD. The first is about Diagnosing ADHD in Children. The second is about treatment - specifically Neurofeedback.

FREE Copy of Master Your Money: Paying Bills On Time with Adult ADD

Click the link to get a free copy of Master Your Money: Paying Bills On Time with Adult ADD. In these times of economic hardship, we could probably all take a few lessons!

http://www.additudemag.com/RCLP/sub/2750.html

Do You Have Adult ADHD? Why Diagnosis Is Critical

The following is a brief article from attitudemag.com

Attention deficit disorder (ADD ADHD) is being diagnosed in adults in their 20s, 30s, or, in some cases, in grandparents who are in their mid-60s.

Many adults with ADHD say that they weren't even aware of the disorder until they had a child who was diagnosed. After seeing ADHD in their children, these undiagnosed adults gradually realized that they had the same signs and symptoms. Why would it be important to diagnose someone has made it through school, has a job, and has somehow managed to hang around the planet for more than a quarter of a century?

ADHD is not some monolithic diagnosis that affects all people the same way. Some people with ADHD have learning disorders, some do not. Some ADHD people are extremely intelligent, others have average or even below average IQ. Some come from supportive homes, others come from dysfunctional families and had to raise themselves. All of these factors affect the impact of ADHD on the life of the individual. The child genius who has supportive parents will be better able to compensate for his or her ADHD.

Many ADHD adults have learned to hide their cluttered desks behind closed office doors; they learn to look attentive even when they have no idea what has just been said. These and other survival skills help to cloak their ADHD.

But, eventually, even the child genius finds that coping skills only go so far. Frustration becomes more apparent as the gap between ability and actual performance grows. After years of being able to get by on innate intelligence and other abilities, these undiagnosed ADHD adults realize that there is nothing left in their bag of tricks.

Research on ADHD adults illustrates the scope of the problem. Twenty-five percent of ADHD participants in the study did not graduate from high school versus 1% of the participants who did not have ADHD.

On a positive note, half of the ADHD students who did not graduate were able to obtain a General Education Diploma by taking the GED test. Only 15% of ADHD participants had completed a bachelor's degree compared to more than half of the Non-ADHD group having completed a bachelor's degree or higher. Other studies report finding that as few as 5% of AD/HD people who attend college actually obtain a degree (American Journal of Psychiatry, April, 1998)

Three percent of the adults in the ADHD group were enrolled in graduate school or had completed a graduate degree, compared to sixteen percent of those in the Non-ADHD group were either enrolled or had completed a graduate degree program when the follow up survey was conducted.

Education and career goals are not the only reasons why these patients seek treatment. The ADHD adult begins to feel unable to cope, as the responsibilities of marriage, parenting, mortgage payments and more begin to pile on. This frustration may lead to self-medication with illicit drugs or alcohol, both of which present even more problems of their own. Jobs suffer and relationships perish. An overall sense of failure begins to take over.

Breaking this cycle of failure and frustration is the primary goal of treatment for the ADHD adult.

Introduction to ADHD Coaching

The following is an excerpt from my 2007 Dissertation study, "ADHD Coaching and College Students"

ADHD coaching helps the individual to problem solve various manifestations of their disability (Quinn et al., 2000) and a growing amount of research suggests its utility. However, the lack of empirical studies documenting its effectiveness has left many scientists and practitioners skeptical about the efficacy of coaching as an intervention for individuals with ADHD. Still, many professionals feel that ADHD coaching has the potential to be an effective treatment (Swartz, Prevatt, & Proctor, 2005).

ADHD coaching derives from the coaching model used in executive coaching and athletics, the latter which has also been the impetus for life skills coaching (Quinn et al., 2000). Coaching involves helping clients deal with aspects of their disability that interfere with academic performance and coping with difficulties such as procrastination, lack of concentration, ineffective self-regulation, poor planning, anxiety, social incompetence, or time management. Useful strategies for ADHD college students to learn include organizational skills, time-management, goal setting, and specific study skills (Finn, 1998; Willis, Hoben, & Myette, 1995). As opposed to traditional counseling and psychotherapeutic methods, ADHD coaching puts the students’ needs and interests at the center, fitting the program to the student rather than fitting the student to the system, extending to all aspects of ADHD individuals’ life (McCormick, 1998).

Coaching is similar to traditional counseling in several ways (Jaska & Ratey, 1999). Coaching and counseling are similar in that both coaching and therapy establish helping relationships that are supportive, respectful of client’s needs, confidential, and free of manipulation or abuse, work on setting goals and assessing priorities, and require a client who is willing to elicit change. Unlike counselors, coaches do not explore serious emotional, cognitive, or behavioral problems of clinical intensity, such as depression, anxiety or substance abuse (Jaska & Ratey, 1999). Therapy is about insight; coaching is about action and getting things done (Favorite, 1995). It is a pragmatic, behavioral, results-oriented, “just do it” sort of approach, as opposed to a process, insight-oriented, intellectual approach. In Nancy Ratey’s (2002) words, “Coaching focuses on what, how, and when—never why.” Coaching operates from a premise that the client is ready, willing, and able to work in a partnership with the coach and rise to the challenge of creating a better life (Ratey, 2002). If any emotional issues arise during the coaching process, the coach must have resources to refer the client. It is important that the coach have a working knowledge of psychological disorders in order to refer clients with more serious problems.

A coach may deal with feelings such as frustration, fear of failure, avoidance behavior, and loss of confidence. However, these feelings are dealt with in terms of what motivates client’s behavior and helps/hinders goal achievement. Coaching is based on a holistic, “wellness” model, intended to improve daily functioning and well-being or individuals without significant psychological impairment. It is an educational process rather than a treatment process. Coaches do not have to be licensed, formally trained, or possess a formal degree. Coaching is also more flexible than therapy since in-person meetings are not essential. Coaches and therapists can sometimes simultaneously work with a client, but boundaries must be made clear.

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I highly recommend this magazine (but I am in no way associated with it nor benefit from it's sales) . It is brought to you by CHADD, a terrific organization -- all things ADHD. Click the link above to subscribe.

ADHD and Academic Difficulties

The following is an excerpt from my 2007 Dissertation Study entitled,
"ADHD Coaching and College Students"

ADHD and Academic Difficulties

There are three subtypes of ADHD: Predominantly Inattentive, Predominantly Hyperactive/Impulsive, and the Combined Type. In the Predominantly Inattentive type, the individual experiences the symptoms of inattention at the clinical level, but not the hyperactive-impulsive symptoms. In the Predominantly Hyperactive-Impulsive type, the individual experiences the symptoms of hyperactivity and impulsivity at the clinical level, but not the symptoms of inattention. In the Combined type, the individual shows clinical levels of symptoms of inattention, hyperactivity, and impulsivity (APA, 2000).

While students with ADHD seem capable of learning, their hyperactivity, impulsivity, and/or inattention make concentration difficult and negatively affects their performance (Fowler, 1994). Both motor and verbal hyperactivity may keep these individuals from being able to sit quietly during lectures. Impulsivity causes difficulty in any task requiring a delay such as raising hands to answer questions, reading or listening to directions, asking questions to clarify information, planning, and organizing (Zentall, 1993). Inattention leads to problems focusing on tasks and assignments.

Traditional school practices make academia an ordeal for many students with ADHD. The current degree of fit between the within-person variables of an individual with ADHD and standard classroom environmental variables is not effectively producing a successful outcome for students with the disorder. Students with ADHD risk school failure at a higher rate than students without disabilities who have equivalent intelligence (Rubinstein & Brown, 1981). As children, individuals with ADHD struggle with failure rates double to triple those of other children, with about 50 percent repeating a grade by adolescence (Ingersoll, 1988). One early study reported that 80% of students classified as having ADHD scored at least two years below their peers on measures of reading, spelling, math, or written language (Anderson, Williams, McGee, & Sylva, 1987).

Some studies have shown that younger students with ADHD may exhibit deficits in a specific academic skill. For example, one study found that approximately 15% of children and adolescents classified as having ADHD presented with profiles similar to students classified as having reading disorders (Aaron, Joshi, Palmer, Smith, & Kirby, 2002). Controlling for IQ and phonological processing skills, another study found that children and adolescents classified as having ADHD do not exhibit deficits in reading vocabulary (Nussbaum, Grant, Roman, Poole, & Bigler, 1990) or have problems with the comprehension of short passages (Javorsky, 1996). Instead, students classified as having ADHD had problems with the comprehension of longer passages (McGee, Partridge, Williams, & Silva, 1991).

In spelling, studies (that have controlled for IQ differences) have found that students classified as having ADHD score lower on standardized measures of spelling than their peers without disabilities (e.g., August & Garfinkel, 1990). Although spelling is primarily a phonological-orthographic (sound and sound-symbol) task, some researchers have suggested that the spelling problems of students classified as having ADHD may also be, in part, a selective attention task (e.g., Zentall, 1993). One study showed that the spelling performance of students classified as having ADHD could be improved simply through practice with target words (Fitzgerald, Fick, & Milich, 1986).

In math, studies have shown that students classified as having ADHD performed significantly lower than their peers without ADHD on timed tasks of math calculation, even when differences in IQ were controlled (Ackerman, Anhalt, Holcomb, & Dykman, 1986; Zentall, 1990; Zentall, Smith, Lee, & Wieczorek, 1994). As in the studies of spelling, researchers have speculated that the slower speed of students classified as having ADHD on math tasks might be attributed to their inability for sustained attention on repetitive tasks and lack of mastery of rote skills. Other studies suggest that students classified as having ADHD may have more difficulty on timed math tasks because of a combination of weaker computational skills, slower visual-motor speed, and more off-task behaviors (Barkley, Anastopoulos, Guevremont, & Fletcher, 1991; Zentall, 1990).

In addition to specific problems with one academic area such as reading, spelling, or math, researchers have reported that younger students classified as having ADHD exhibit handwriting difficulties; however, the reasons for these difficulties may be confounded by other factors. When controlling for visual-motor skill, for example, differences in handwriting errors between students classified as having ADHD and students without the disorder were not significant (Zentall & Kruczek, 1988). This finding suggests that the handwriting difficulties of students classified as having ADHD may be due to visual-motor deficits (Zentall, 1993). Alternatively, both poor handwriting and deficits in visual-motor skill may be the result of a third variable, failure to sustain attention to tasks that involve repeated practice (Zentall, 1993). Zentall and Kruczek (1988) found that students classified as having ADHD made more errors and had poorer handwriting ratings on a copying task than students without ADHD even after repeated practice on the task.

Barkley (1998) found that adults who were diagnosed with ADHD as children not only had lower levels of educational attainment but also reported having been suspended or expelled from school more often than their counterparts. Taken together, expulsion and dropout rates for these students approach 50 percent. Studies suggest that these early failures in academia lead to a lifelong downward spiral in terms of academic performance for students with ADHD.

Please contact me for a full list of references.